The Role of Clinical Engineering in Management and Decision-Making in Brazilian Hospitals

Abstract

In an ever-changing hospital landscape, where technology intertwines with health care, clinical engineering emerges as a beacon to guide medical equipment management. But how do managers perceive the role of this crucial area? This study aims to unravel this question by exploring the views of 25 public and private hospitals across Brazil. Equipped with a carefully crafted online questionnaire, we embarked on an exploratory expedition, using Google Forms® as our map. Through the responses of 25 hospitals, we unraveled the structure and performance of clinical engineering, seeking to understand its relevance in hospital management. Following Donabedian’s footsteps, we evaluated quality through three lenses: structure, processes, and outcomes. The responses revealed that clinical engineering plays a pivotal role in equipment management, the pursuit of accreditation seals, and strategic planning, proving its growing importance. In spite of the limited scope (only 25 out of over 7,100 Brazilian hospitals), the responses provided a glimpse into the evolution of clinical engineering. More than that, they revealed gaps that call for more in-depth research, opening up a range of possibilities for future studies. This study serves as a beacon for hospital managers, illuminating the path to structuring a robust and effective clinical engineering department. Clinical engineering is not limited to mere operation but rather stands as a strategic ally in the pursuit of excellence in health care. The results of this study indicate that, although clinical engineering is still largely viewed as an operational function, its role in the surveyed hospitals shows a clear movement toward greater strategic relevance. Managers increasingly recognize its value in cost management, investment decision-making, contract oversight, participation in institutional projects, and contributions to organizational strategy. When interpreted through the Donabedian model, the findings suggest that more structured departments—particularly those aligned with Health Technology Assessment HTA committees—tend to produce stronger organizational outcomes. In spite of variations in structure, hierarchy, and employment models, evidence shows that clinical engineering plays an expanding role in enhancing care effectiveness, optimizing the technology fleet, and promoting the sustainability of health care services. Overall, the study points to a gradual maturation of the field, in which strengthening its technical and managerial leadership becomes essential for continuous hospital improvement. Through continuous and in-depth research, we can further unlock the potential of this crucial area for the future of health.